Amanda Shepard, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

020012581 Issued in IL

Practice address

7562 Old Route 13
Marion, IL 62959-7776

Phone

(618) 993-8333

Fax

(618) 993-8335

NPI assigned

Oct 19, 2022

Last updated

Oct 19, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dental Safari Company, LTD

  • General Practice Dentistry
  • Marion, IL
  • NPI 1427357631
  NPD
• Dental Safari Co Missouri, PC

  • Dentist
  • O'Fallon, MO
  • NPI 1811761190
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1437876562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7562 OLD ROUTE 13",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629597776",
            "telephone_number": "618-993-8333",
            "fax_number": "618-993-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7562 OLD ROUTE 13",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629597776",
            "telephone_number": "618-993-8333",
            "fax_number": "618-993-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPARD",
        "first_name": "AMANDA",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "IL",
            "license": "020012581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawnee Health Service and Development Corp (Lincoln Elementary School Health Center)
• Leah Christine Sheffer, PHARMD
• Cole Curran Shelton
• Jeremy Adair Shelton, RRT
• Susan Elaine Shelton, LCSW, DCSW, BCD
• Susan Shoot, RN
• Leslie Elizabeth Shoraga
• Si Medical, Inc.
• Amy Lynn Simpson, O.D.
• Robert (Bob) Wayne Simpson

• Dental Hygienist in Marion, IL
• Providers in Marion, IL by specialty
• Dental Hygienist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.